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Abstract：
OBJECTIVE: To compare the clinical outcomes of primary metal-on-metal total hip replacement (MoM-TR) converted to uncemented total hip replacement (UTR) or cemented total hip replacement (CTR) in patients with femoral neck fractures (AO/OTA: 31B/C).
METHODS: Patient data of 234 UTR or CTR revisions after primary MoM-TR failure from March 2007 to January 2018 were retrospectively identified. Clinical outcomes, including the Harris hip score (HHS) and key orthopaedic complications, were collected at 3, 6, and 12 months following conversion and every 12 months thereafter.
RESULTS: The mean follow-up was 84.12 (67-100) months for UTR and 84.23 (66-101) months for CTR. At the last follow-up, the HHS was better in the CTR- than UTR-treated patients. Noteworthy dissimilarities were correspondingly detected in the key orthopaedic complication rates (16.1% for CTR vs. 47.4% for UTR). Statistically significant differences in specific orthopaedic complications were also detected in the re-revision rate (10.3% for UTR vs. 2.5% for CTR), prosthesis loosening rate (16.3% for UTR vs. 5.9% for CTR), and periprosthetic fracture rate (12.0% for UTR vs. 4.2% for CTR).
CONCLUSIONS: In the setting of revision of failed primary MoM-TR, CTR may demonstrate advantages over UTR in improving functional outcomes and reducing key orthopaedic complications.
METHODS: Patient data of 234 UTR or CTR revisions after primary MoM-TR failure from March 2007 to January 2018 were retrospectively identified. Clinical outcomes, including the Harris hip score (HHS) and key orthopaedic complications, were collected at 3, 6, and 12 months following conversion and every 12 months thereafter.
RESULTS: The mean follow-up was 84.12 (67-100) months for UTR and 84.23 (66-101) months for CTR. At the last follow-up, the HHS was better in the CTR- than UTR-treated patients. Noteworthy dissimilarities were correspondingly detected in the key orthopaedic complication rates (16.1% for CTR vs. 47.4% for UTR). Statistically significant differences in specific orthopaedic complications were also detected in the re-revision rate (10.3% for UTR vs. 2.5% for CTR), prosthesis loosening rate (16.3% for UTR vs. 5.9% for CTR), and periprosthetic fracture rate (12.0% for UTR vs. 4.2% for CTR).
CONCLUSIONS: In the setting of revision of failed primary MoM-TR, CTR may demonstrate advantages over UTR in improving functional outcomes and reducing key orthopaedic complications.
摘要：
目的：比较股骨颈骨折（AO/OTA：31B/C）患者原发金属对金属全髋关节置换术（MoM-TR）转换为非骨水泥全髋关节置换术（UTR）或骨水泥全髋关节置换术（CTR）的临床结果。
方法：回顾性鉴定2007年3月至2018年1月原发性MoM-TR失败后234例UTR或CTR修订的患者数据。临床结果,包括Harris髋关节评分（HHS）和主要的骨科并发症，在转化后3、6和12个月以及此后每12个月收集。
结果：UTR的平均随访时间为84.12（67-100）个月，CTR的平均随访时间为84.23（66-101）个月。在最后一次随访中，CTR治疗患者的HHS优于UTR治疗患者.在关键的骨科并发症发生率中相应地发现了值得注意的差异（CTR与CTR的16.1%UTR为47.4%）。在重新修订率方面也检测到特定骨科并发症的统计学差异（UTR的10.3％与CTR为2.5%)，假体松动率（UTR的16.3%与5.9%的CTR），和假体周围骨折率(UTR的12.0%与CTR为4.2%）。
结论：在设置失败的主要MoM-TR的修订时，CTR在改善功能结果和减少关键骨科并发症方面可能比UTR更具优势。
方法：回顾性鉴定2007年3月至2018年1月原发性MoM-TR失败后234例UTR或CTR修订的患者数据。临床结果,包括Harris髋关节评分（HHS）和主要的骨科并发症，在转化后3、6和12个月以及此后每12个月收集。
结果：UTR的平均随访时间为84.12（67-100）个月，CTR的平均随访时间为84.23（66-101）个月。在最后一次随访中，CTR治疗患者的HHS优于UTR治疗患者.在关键的骨科并发症发生率中相应地发现了值得注意的差异（CTR与CTR的16.1%UTR为47.4%）。在重新修订率方面也检测到特定骨科并发症的统计学差异（UTR的10.3％与CTR为2.5%)，假体松动率（UTR的16.3%与5.9%的CTR），和假体周围骨折率(UTR的12.0%与CTR为4.2%）。
结论：在设置失败的主要MoM-TR的修订时，CTR在改善功能结果和减少关键骨科并发症方面可能比UTR更具优势。
